This 48 year old gentleman had a history of recurrent pancreatitis. MRCP showed calculi in the distal and middle pancreatic duct (A: green arrows) and calcification in the region of pancreatic head (A: red arrows). The ultrasound report indicated the presence of small calculi in the distal CBD in addition to the pancreatic duct calculi. On ERCP, the CBD was cannulated, followed by contrast injection which did not show any stones. The CBD showed distal tapering (B: green arrows - which may be due to pressure from the calcified pancreatic head). We did a papillotomy followed by sweep with balloon which also didn't result in any stone or sludge. Despite repeated attempts, we couldn't cannulate the pancreatic duct. The case has now been rescheduled to a later date.
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